Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Intrathecal rituximab for EBV-associated post-transplant lymphoproliferative disorder with central nervous system involvement unresponsive to intravenous rituximab-based treatments: a prospective study

Bone Marrow Transplantation volume 51, pages 456–458 (2016)Cite this article

Subjects

EBV-associated post-transplant lymphoproliferative disorder (PTLD) is a lift-threatening complication in recipients of allogeneic hematopoietic stem cell transplantation (allo-HSCT).1, 2 The incidence of PTLD ranges from 0.2 to 22% in allo-HSCT recipients, depending on the number of risk factors.3, 4 Although the introduction of rituximab as a first-line treatment has improved outcome of PTLD, PTLD with central nervous system (CNS-PTLD) involvement still has a dismal prognosis because of low penetrance of rituximab across the blood-brain barrier.5, 6, 7 In this prospective study, we reported the successful treatment with intrathecal rituximab in CNS-PTLD who had failed to respond to the IV rituximab-based treatments.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Get just this article for as long as you need it

$39.95

Learn more

Prices may be subject to local taxes which are calculated during checkout

References

  1. Jagadeesh D, Woda BA, Draper J, Evens AM . Post transplant lymphoproliferative disorders: risk, classification, and therapeutic recommendations. Curr Treat Options Oncol 2012; 13: 122–136.

    Article  PubMed  Google Scholar 

  2. Fox CP, Burns D, Parker AN, Peggs KS, Harvey CM, Natarajan S et al. EBV-associated post-transplant lymphoproliferative disorder following in vivo T-cell-depleted allogeneic transplantation: clinical features, viral load correlates and prognostic factors in the rituximab era. Bone Marrow Transplant 2014; 49: 280–286.

    Article  CAS  PubMed  Google Scholar 

  3. Landgren O, Gilbert ES, Rizzo JD, Socie G, Banks PM, Sobocinski KA et al. Risk factors for lymphoproliferative disorders after allogeneic hematopoietic cell transplantation. Blood 2009; 113: 4992–5001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Curtis RE, Travis LB, Rowlings PA, Socie G, Kingma DW, Banks PM et al. Risk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study. Blood 1999; 94: 2208–2216.

    CAS  PubMed  Google Scholar 

  5. Evens AM, David KA, Helenowski I, Nelson B, Kaufman D, Kircher SM et al. Multicenter analysis of 80 solid organ transplantation recipients with post-transplantation lymphoproliferative disease: outcomes and prognostic factors in the modern era. J Clin Oncol 2010; 28: 1038–1046.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Reddy N, Rezvani K, Barrett AJ, Savani BN . Strategies to prevent EBV reactivation and posttransplant lymphoproliferative disorders (PTLD) after allogeneic stem cell transplantation in high-risk patients. Biol Blood Marrow Transplant 2011; 17: 591–597.

    Article  PubMed  Google Scholar 

  7. Bonney DK, Htwe EE, Turner A, Kelsey A, Shabani A, Hughes S et al. Sustained response to intrathecal rituximab in EBV associated Post-transplant lymphoproliferative disease confined to the central nervous system following haematopoietic stem cell transplant. Pediatr Blood Cancer 2012; 58: 459–461.

    Article  PubMed  Google Scholar 

  8. Abrey LE, Batchelor TT, Ferreri AJ, Gospodarowicz M, Pulczynski EJ, Zucca E et al. Report of an international workshop to standardize baseline evaluation and response criteria for primary CNS lymphoma. J Clin Oncol 2005; 23: 5034–5043.

    Article  PubMed  Google Scholar 

  9. Xuan L, Jiang X, Sun J, Zhang Y, Huang F, Fan Z et al. Spectrum of Epstein-Barr virus-associated diseases in recipients of allogeneic hematopoietic stem cell transplantation. Transplantation 2013; 96: 560–566.

    Article  CAS  PubMed  Google Scholar 

  10. Cavaliere R, Petroni G, Lopes MB, Schiff D . Primary central nervous system post-transplantation lymphoproliferative disorder: an International Primary Central Nervous System Lymphoma Collaborative Group Report. Cancer 2010; 116: 863–870.

    Article  PubMed  Google Scholar 

  11. Buell JF, Gross TG, Hanaway MJ, Trofe J, Roy-Chaudhury P, First MR et al. Posttransplant lymphoproliferative disorder: significance of central nervous system involvement. Transplant Proc 2005; 37: 954–955.

    Article  CAS  PubMed  Google Scholar 

  12. Blaes AH, Peterson BA, Bartlett N, Dunn DL, Morrison VA . Rituximab therapy is effective for posttransplant lymphoproliferative disorders after solid organ transplantation: results of a phase II trial. Cancer 2005; 104: 1661–1667.

    Article  CAS  PubMed  Google Scholar 

  13. Rubenstein JL, Fridlyand J, Abrey L, Shen A, Karch J, Wang E et al. Phase I study of intraventricular administration of rituximab in patients with recurrent CNS and intraocular lymphoma. J Clin Oncol 2007; 25: 1350–1356.

    Article  CAS  PubMed  Google Scholar 

  14. Czyzewski K, Styczynski J, Krenska A, Debski R, Zajac-Spychala O, Wachowiak J et al. Intrathecal therapy with rituximab in central nervous system involvement of post-transplant lymphoproliferative disorder. Leuk Lymphoma 2013; 54: 503–506.

    Article  CAS  PubMed  Google Scholar 

  15. Harjunpaa A, Wiklund T, Collan J, Janes R, Rosenberg J, Lee D et al. Complement activation in circulation and central nervous system after rituximab (anti-CD20) treatment of B-cell lymphoma. Leuk Lymphoma 2001; 42: 731–738.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The study was supported by grants from the National Natural Science Foundation of China (No. 81000231, No. 81270647 and No. 81400141), the National Public Health Grand Research Foundation of China (No. 201202017), the Natural science foundation of Guangdong province (No. S2012010009299) and Foundation of President of Nanfang Hospital (No. 2013Z004). We thank Professor Chunrong Tong for providing EBV-CTLs from Beijing Daopei Hospital and Professor Mohamad Mohty from Saint-Antoine Hospital for editing and revising of this paper.

Author information

Authors and Affiliations

  1. Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China

    M Wu, J Sun, Y Zhang, F Huang, H Zhou, Z Fan, L Xuan, G Yu, X Guo, M Dai, R Feng & Q Liu

Authors
  1. M Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Z Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L Xuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. G Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. X Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M Dai
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. R Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Q Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Q Liu.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wu, M., Sun, J., Zhang, Y. et al. Intrathecal rituximab for EBV-associated post-transplant lymphoproliferative disorder with central nervous system involvement unresponsive to intravenous rituximab-based treatments: a prospective study. Bone Marrow Transplant 51, 456–458 (2016). https://doi.org/10.1038/bmt.2015.281

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2015.281

This article is cited by

Search

Advanced search

Quick links